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Take it from those who know: If you’re just beginning to implement quality improvement programs at your facility, Six Sigma is not for you. And even if you have a lot of experience under your belt, be aware that Six Sigma is not a one-size-fits-all solution to your quality problems.
"You must recognize that if this is your first step into continuous improvement, Six Sigma is not the way to learn how to walk," warns Randall Linton, MD, incoming president and CEO of Luther Midelfort-Mayo Health System in Eau Claire, WI. "Your background in quality will significantly enhance your experience. "Prior to looking at Six Sigma, our organization had a greater than 10-year history of continuous improvement," Linton continues.
"This is a very crucial point. We found from our experience, and in working with the [Boston-based] Institute for Healthcare Improvement as one of our strategic partners, that using a variety of different models and methods is a good approach," he points out. "With that history, we have evolved to the point where we started to look at Six Sigma about two to three years ago and to investigate what it might mean for us," Linton says.
"I think your chances of success will be greater if Six Sigma is used in the context of a systemwide initiative, such as our current Star Initiative," adds Walter H. Ettinger, MD, MBA, executive vice president of Virtua Health System in Marlton, NJ. "It’s a tool to achieve a goal. Also, you have to be willing to put significant resources into this; you’ve got to have perseverance and patience."
Six Sigma addresses but one component of success in performance improvement, he adds. "We refer to the equation, Q [quality] x A [acceptance of the new process] = E [effective results]. Six Sigma is the quality component of the solution."
"If you only do the Six Sigma piece, you won’t get there," adds Carol P. Mullin, RN, MSN, a Six Sigma black belt at Virtua. "If you do it by itself, it’s too little. Getting the Q’ piece is an improvement, but the Q’ side is easy in health care; you’re never going to be successful unless you work out the A’ pieces. And in health care, we’re not too good at the A.’ Around here, we like to say, "It’s the A,’ stupid! That’s what makes for lasting change."
Finally, cautions Linton, Six Sigma is not the tool to use for every project — just the untouchables. "For example, [Plan Do Study Act] is a big part [of our quality improvement process] and will continue to be. Six Sigma is another tool in the toolbox. In many areas, other models are much simpler and cheaper."
For more on Six Sigma, contact:
• Traci Atherton, RN, BSN, Vice President of Clinical Support, Baylor Grapevine, 1650 W. College, Grapevine, TX 76051. (817) 329-2682. Fax: (817) 424-4700. E-mail: email@example.com.
• Randall Linton, MD, Luther Midelfort-Mayo Health System, 1400 Bellinger Street, Eau Claire, WI 54701. Telephone: (715) 838-3312. E-mail: firstname.lastname@example.org.
• Carol P. Mullin, RN, MSN, Virtua Health System, Marlton, NJ. Telephone: (856) 355-0070.
• Erich Florentine, Virtua Health System, Vice President, Operations Improvement, Marlton, NJ. Telephone: (856) 355-0070.
• Walter H. Ettinger, MD, MBA, Executive Vice President, Marlton, NJ. Telephone: (856) 355-0070.